Active NPI
Mahmoud Farhat, PA-C
- Physician Assistant
- McHenry, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 085010446
- Practice address
- 4309 W Medical Center Dr Ste A200
McHenry, IL 60050-8437 - Phone
- (815) 759-8070
- Fax
- (815) 759-4931
- NPI assigned
- Jun 28, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | 5601011868 | MI | |
| Surgical Physician Assistant | 363AS0400X | IL | ||
| Physician Assistant | 363A00000X | 085010446 | IL | Primary |
Addresses
Primary practice location
4309 W Medical Center Dr Ste A200
McHenry, IL 60050-8437
Mailing address
4309 W Medical Center Dr Ste A200
McHenry, IL 60050-8437
Phone (815) 759-8070
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4201 W Medical Ctr Dr
McHenry, IL 60050-8409
Phone (815) 759-4323
515 Valley View Dr
Suite 201
Moline, IL 61265-6175
Phone (312) 695-0870
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 085010446 | IL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Endeavor Health Medical Group | Current | Accepting new patients | |
| Northwestern Medical Faculty Foundation | Current | Accepting new patients | |
| Northwestern Medical Faculty Foundation | Current | Accepting new patients | |
| St Joseph Mercy Hospital | Past | Accepting new patients | |
| Central Dupage Physician Group | Past | Accepting new patients |
Locations
2151 Waukegan Rd
Bannockburn, IL 60015
Phone (847) 236-1300
Dept 5777
Carol Stream, IL 60122
9532 Eagle Way
Chicago, IL 60678
2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222
10370 Haligus Rd
Ste 200
Huntley, IL 60142
Phone (815) 759-8070
660 N Westmoreland Rd
Lake Forest, IL 60045
Phone (847) 535-6100
660 N Westmoreland Rd
#302
Lake Forest, IL 60045
4309 W Medical Center Dr
Ste A200
McHenry, IL 60050
Phone (815) 759-4699
515 Valley View Dr
Ste 201
Moline, IL 61265
Phone (312) 695-0870
Interoperability endpoints
- mfarhat2890571@direct.trinity-health.org
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Northwestern Medical Group
- Multi-Specialty Clinic/Center
- Carol Stream, IL
- NPI 1346235314
-
dba NorthShore University HealthSystem Faculty Practice Associates
- Emergency Medicine Physician
- Evanston, IL
- NPI 1497701882
-
dba Northwestern Medical Group
- Durable Medical Equipment & Medical Supplies
- Chicago, IL
- NPI 1417718479
-
dba Northwestern Medicine Regional Medical Group
- Family Medicine Physician
- Carol Stream, IL
- NPI 1033149844
-
- Certified Registered Nurse Anesthetist
- Howell, MI
- NPI 1265497705
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Centegra Hospital McHenry
- General Acute Care Hospital
- McHenry, IL
- NPI 1982611281
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755129600000",
"number": "1922785310",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4309 W MEDICAL CENTER DR STE A200",
"city": "MCHENRY",
"state": "IL",
"postal_code": "600508437",
"telephone_number": "815-759-8070",
"fax_number": "815-759-4931"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4309 W MEDICAL CENTER DR STE A200",
"city": "MCHENRY",
"state": "IL",
"postal_code": "600508437",
"telephone_number": "815-759-8070",
"fax_number": "815-759-4931"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FARHAT",
"first_name": "MAHMOUD",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-06-28",
"last_updated": "2025-08-14",
"certification_date": "2025-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "MI",
"license": "5601011868",
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "IL",
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IL",
"license": "085010446",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in McHenry, IL
- Shawn Marten Falitz, M.D.
- Family Service & Community Mental Health Center for McHenry County
- Family Service and Community Mental Health Center for McHenry County
- Family Service and Community Mental Health Center for McHenry County
- Aaron Michael Farber, D.O.
- Lindsey Farlow, D.O.
- Farhan Farooqui, MD
- Drew Farr
- Taiwo M Fasehun, M.D.
- Aalima Fatima, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.